1
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Schweiger L, Hafner F, Meinitzer A, Brodmann M, Dejaco C, Jud P. Association of clinical, imaging and laboratory parameters with adverse effects of glucocorticoid therapy in patients with giant cell arteritis. Front Med (Lausanne) 2024; 11:1382946. [PMID: 38841591 PMCID: PMC11150613 DOI: 10.3389/fmed.2024.1382946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/07/2024] [Indexed: 06/07/2024] Open
Abstract
Background Giant cell arteritis (GCA) is characterized by inflammation of large and medium vessels. First-line therapy for the treatment of GCA are glucocorticoids, which are effective while potential adverse effects should be considered, especially during long-term use. The aim was to investigate the incidence of glucocorticoids' adverse effects and potential predictors for them. Materials and methods 138 GCA patients were retrospectively evaluated for newly developed glucocorticoid adverse effects in 2020. Potential predictors, defined as initial glucocorticoid pulse therapy, relapse of GCA and concomitant polymyalgia rheumatica as well as parameters of inflammation and endothelial dysfunction, including pulse-wave velocity and intima-media-thickness, were measured in 2012. Results Potential new glucocorticoid adverse effects per patient was 1 (25th-75th 0-3) of which chronic kidney disease progression (29%), bone fractures (23.2%), cataracts (18.1%), dementia, and arterial hypertension (each at 12.3%) were most commonly recorded. Significant associations were found between occurrence of any relapse and new diabetes mellitus and between initial glucocorticoid pulse therapy and new dementia (all with p < 0.05). In multivariate regression analysis, any relapse was a predictor for developing diabetes mellitus (OR 9.23 [95% CI 1.33-64.05], p = 0.025). However, no correlations were observed between endothelial dysfunction or inflammatory parameters and development of new glucocorticoid adverse effects. Conclusion GCA relapses may be associated for development of diabetes mellitus potentially by increasing glucocorticoid doses. Parameters of inflammation and endothelial dysfunction are not suited predictors for glucocorticoid adverse effects.
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Affiliation(s)
- Leyla Schweiger
- Division of Angiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Franz Hafner
- Division of Angiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Andreas Meinitzer
- Institute of Medical and Chemical Laboratory Diagnostics, Medical University Graz, Graz, Austria
| | - Marianne Brodmann
- Division of Angiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Christian Dejaco
- Division of Rheumatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- Department of Rheumatology, Hospital of Brunico (SABES-ASDAA), Brunico, Italy
| | - Philipp Jud
- Division of Angiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
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2
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Grabitz C, Sugianto RI, Doyon A, Azukaitis K, Anarat A, Bacchetta J, Bayazit AK, Bulut IK, Caliskan S, Canpolat N, Duzova A, Habbig S, Harambat J, Kiyak A, Longo G, Obrycki L, Paripovic D, Söylemezoğlu O, Thurn-Valsassina D, Yilmaz A, Shroff R, Schaefer F, Schmidt BMW, Melk A. Long-term Effects of Kidney Transplantation Compared With Dialysis on Intima-media Thickness in Children-Results From the 4C-T Study. Transplantation 2024; 108:1212-1219. [PMID: 38227773 DOI: 10.1097/tp.0000000000004881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
BACKGROUND Children requiring kidney replacement therapy experience high burden of cardiovascular (CV) disease leading to increased mortality. Intima-media thickness (IMT) indicating atherosclerosis is a validated surrogate marker for future CV events. METHODS We investigated the effect of different treatment modalities (dialysis, preemptive kidney transplantation (KTx), late KTx after dialysis) on IMT by multivariable linear mixed-effect modeling. Patients were enrolled in a prospective cohort study. RESULTS A total of 261 analyzed children had a mean follow-up of 3 y. Children after preemptive and late KTx had lower levels of IMT when compared with dialysis. Using an interaction term, a significant progression of IMT over time was seen during dialysis (β = 0.0053 mm/y, P = 0.004). IMT before the start of therapy was the most influential determinant in all models. Low IMT was associated with maintenance steroid treatment after preemptive KTx. High IMT on dialysis was associated with higher systolic blood pressure, lower body mass index, lower serum albumin, and lower bicarbonate. CONCLUSIONS IMT remained rather stable in children several years after KTx. In contrast, children on dialysis had higher IMT values, which increased over time. In these children, blood pressure control, calorie and protein intake, and acid-base homeostasis seem important. Taken together, children might profit from early transplantation to limit accumulation of CV risk.
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Affiliation(s)
- Carl Grabitz
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Rizky I Sugianto
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Anke Doyon
- Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Karolis Azukaitis
- Clinic of Pediatrics, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Ali Anarat
- Department of Pediatrics, Faculty of Medicine, Cukurova Universitesi, Adana, Turkiye
| | | | - Aysun K Bayazit
- Department of Pediatrics, Faculty of Medicine, Cukurova Universitesi, Adana, Turkiye
| | - Ipek K Bulut
- Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkiye
| | - Salim Caliskan
- Department of Pediatric Nephrology, Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkiye
| | - Nur Canpolat
- Department of Pediatric Nephrology, Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkiye
| | - Ali Duzova
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkiye
| | - Sandra Habbig
- Department of Pediatrics, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Jerome Harambat
- Department of Pediatrics, Nephrology Unit, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Aysel Kiyak
- Division of Pediatric Nephrology, Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, Turkiye
| | - Germana Longo
- Department of Women's and Children's Health, University of Padua, Padova, Veneto, Italy
| | - Lukasz Obrycki
- Department of Nephrology, Kidney Transplantation and Arterial Hypertension, The Children's Memorial Health Institute, Warsaw, Poland
| | - Dusan Paripovic
- Department of Nephrology, Children's Hospital, University of Belgrade, Belgrade, Serbia
| | - Oğuz Söylemezoğlu
- Department of Pediatric Nephrology, School of Medicine, Gazi University, Ankara, Turkiye
| | - Daniela Thurn-Valsassina
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Alev Yilmaz
- Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkiye
| | - Rukshana Shroff
- Renal Unit, UCL Great Ormond Street Hospital and Institute of Child Health, London, United Kingdom
| | - Franz Schaefer
- Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Bernhard M W Schmidt
- Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
| | - Anette Melk
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
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3
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Misra DP, Sharma A, Karpouzas GA, Kitas GD. Cardiovascular risk in vasculitis. Best Pract Res Clin Rheumatol 2023; 37:101831. [PMID: 37302927 DOI: 10.1016/j.berh.2023.101831] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/06/2023] [Accepted: 04/16/2023] [Indexed: 06/13/2023]
Abstract
The present review summarizes the burden, risk factors, biomarkers of and therapeutic consideration for cardiovascular disease in systemic vasculitis. Ischemic heart disease (IHD) and stroke are intrinsic features of Kawasaki disease, Takayasu arteritis, Giant Cell Arteritis (GCA), and Behcet's disease. The risk of IHD and stroke is increased in anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) and cryoglobulinemic vasculitis. Behcet's disease could present with venous thromboembolism. The risk of venous thromboembolism is increased in AAV, polyarteritis nodosa, and GCA. The risk of cardiovascular events is greatest at or immediately after the diagnosis of AAV or GCA, therefore, controlling vasculitis disease activity is of utmost importance. Traditional as well as disease-related risk factors drive the heightened cardiovascular risk in vasculitis. Aspirin or statins reduce the risk of IHD or stroke in GCA or the risk of IHD in Kawasaki Disease. Venous thromboembolism in Behcet's disease should be treated with immunosuppressive therapy rather than with anticoagulation.
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Affiliation(s)
- Durga Prasanna Misra
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, 226014, India.
| | - Aman Sharma
- Clinical Immunology and Rheumatology Wing, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, India.
| | | | - George D Kitas
- Research & Development, Dudley Group NHS Foundation Trust and University of Birmingham, UK.
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4
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de Boysson H, Aouba A. An Updated Review of Cardiovascular Events in Giant Cell Arteritis. J Clin Med 2022; 11:1005. [PMID: 35207277 PMCID: PMC8878095 DOI: 10.3390/jcm11041005] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/09/2022] [Accepted: 02/15/2022] [Indexed: 02/01/2023] Open
Abstract
Giant cell arteritis (GCA) is a systemic vasculitis with a direct and indirect increased risk of acute and chronic vascular events, affecting large and medium vessels, and responsible for most of the morbidity and mortality of this disease. We aimed in this review to provide an updated synthesis of knowledge regarding cardiovascular events observed in GCA. By definition, GCA patients are over 50 and often over 70 years old, and subsequently also present age-related cardiovascular risk factors. In addition, the systemic and vascular inflammation as well as glucocorticoids (GC) probably contribute to an accelerated atherosclerosis and to vascular changes leading to arterial stenoses and aortic dilations and/or dissections. GCA-related ischemic complications, especially ophthalmologic events, stroke or myocardial infarcts are mostly observed within the first months after the diagnosis, being mainly linked to the vasculitic process. Conversely, aortic complications, including dilations or dissections, generally occur several months or years after the diagnosis, mainly in patients with large-vessel vasculitis. In these patients, other factors such as atherosclerosis, GC-related endothelial damage and vascular wall remodeling/healing probably contribute to the vascular events. GCA management includes the detection and treatment of these previous and newly induced cardiovascular risk factors. Hence, the use of cardiovascular treatments (e.g., aspirin, anticoagulation, statins, anti-hypertensive treatments) should be evaluated individually. Aortic structural changes require regular morphologic evaluations, especially in patients with previous aortitis. The initial or secondary addition of immunosuppressants, especially tocilizumab, an anti-IL-6 receptor antibody, is discussed in patients with GCA-related cardiovascular complications and, more consensually, to limit GC-mediated comorbidities.
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Affiliation(s)
- Hubert de Boysson
- Department of Internal Medicine, Caen University Hospital, Avenue de la Côte de Nacre, 14000 Caen, France;
- Caen University-Normandie, 14000 Caen, France
| | - Achille Aouba
- Department of Internal Medicine, Caen University Hospital, Avenue de la Côte de Nacre, 14000 Caen, France;
- Caen University-Normandie, 14000 Caen, France
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5
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Jud P, Verheyen N, Dejaco C, Haas E, Szolar D, Meinitzer A, Duftner C, Thonhofer R, Gressenberger P, Brodmann M, Hafner F. Prevalence and prognostic factors for aortic dilatation in giant cell arteritis – a longitudinal study. Semin Arthritis Rheum 2021; 51:911-918. [DOI: 10.1016/j.semarthrit.2020.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/16/2020] [Accepted: 11/19/2020] [Indexed: 01/12/2023]
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6
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Santoro L, Birra D, Bosello S, Nesci A, Di Giorgio A, Peluso G, Giupponi B, Zaccone V, Gasbarrini A, Zoli A, Santoliquido A. Subclinical atherosclerosis and endothelial dysfunction in patients with polymyalgia rheumatica: a pilot study. Scand J Rheumatol 2019; 49:68-74. [PMID: 31418315 DOI: 10.1080/03009742.2019.1628297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: The aim of the study was to investigate endothelial function in treatment-naïve polymyalgia rheumatica (PMR) patients and its modification during steroid therapy, in relation to changes in clinical and laboratory parameters.Method: This prospective observational study involved patients with a new diagnosis of PMR according to provisional American College of Rheumatology/European League Against Rheumatism 2012 criteria, who were naïve to steroid therapy, and control subjects matched for age, gender, and comorbidities. All participants underwent clinical and vascular ultrasound evaluations at baseline and after 1, 3, 6, and 12 months of steroid therapy. For the study of endothelial function, we evaluated the brachial artery reactivity, which has emerged as the most well-established technique used in adults, by assessing flow-mediated dilatation (FMD), which measures the endothelium-dependent vasodilatation.Results: Sixteen newly diagnosed PMR patients were compared with a population of 16 matched controls. FMD values in all subjects showed an inverse correlation with the values of erythrocyte sedimentation rate and C-reactive protein. At baseline, the FMD of PMR patients was significantly lower than controls and remained significantly lower with respect to controls until the sixth month of therapy, despite a clinical improvement already being evident after 1 month of therapy.Conclusions: PMR is characterized by an important chronic subclinical inflammatory component. This pilot study demonstrates that affected patients show endothelial dysfunction that slowly responds to steroid therapy. Further studies are needed to investigate the clinical relevance of these observations and, in particular, to monitor the cardiovascular risk profile of PMR patients.
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Affiliation(s)
- L Santoro
- Department of Medicine, Division of Vascular Medicine, A Gemelli IRCCS University Hospital, Rome, Italy
| | - D Birra
- UOC, Department of Rheumatology, A Gemelli IRCCS University Hospital, Rome, Italy
| | - S Bosello
- UOC, Department of Rheumatology, A Gemelli IRCCS University Hospital, Rome, Italy
| | | | - A Di Giorgio
- Department of Medicine, Division of Vascular Medicine, A Gemelli IRCCS University Hospital, Rome, Italy
| | - G Peluso
- UOC, Department of Rheumatology, A Gemelli IRCCS University Hospital, Rome, Italy
| | - B Giupponi
- Department of Emergency Medicine, A Gemelli IRCCS University Hospital, Rome, Italy
| | - V Zaccone
- Department of Internal and Subintensive Medicine, University Hospital Riuniti, Ancona, Italy
| | - A Gasbarrini
- Department of Medicine, Division of Vascular Medicine, A Gemelli IRCCS University Hospital, Rome, Italy.,Catholic University of the Sacred Heart, Rome, Italy
| | - A Zoli
- Catholic University of the Sacred Heart, Rome, Italy.,UOSA, Department of Rheumatology, A Gemelli IRCCS University Hospital, Rome, Italy
| | - A Santoliquido
- Department of Medicine, Division of Vascular Medicine, A Gemelli IRCCS University Hospital, Rome, Italy.,Catholic University of the Sacred Heart, Rome, Italy
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7
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Smoking as a risk factor for giant cell arteritis: A systematic review and meta-analysis. Semin Arthritis Rheum 2018; 48:529-537. [PMID: 30093239 DOI: 10.1016/j.semarthrit.2018.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 07/01/2018] [Accepted: 07/02/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVES To investigate the association between smoking and giant cell arteritis (GCA). METHODS A systematic review was performed and meta-analysis conducted on observational studies that reported absolute numbers and/or statistical comparisons with 95% confidence intervals comparing smoking history and presence of GCA, among patients with GCA and non-GCA controls. Studies were reviewed in accordance with PRISMA guidelines. Point estimates and standard errors were extracted from individual studies and were combined by the generic inverse variance method of DerSimonian and Laird. A random-effects meta-analysis was performed. Statistical heterogeneity was assessed using the Cochran's Q test which was complemented with the I2 statistic. RESULTS The initial search yielded 3312 articles. Of these, thirteen studies (8 prospective and, 5 retrospective case-control studies) with unique cohorts were identified and included in the primary analysis (ever vs. never smoking history). Patients in the GCA cohort were more likely to have a history of smoking with an odds ratio of 1.19 (95% CI, 1.01-1.39). Considerable heterogeneity was present (I2 = 85%). Five of these studies included information on current smoking status. One additional study, which only reported current smoking status, was also included. The GCA cohort showed an association with current smoking with an odds ratio of 1.18 (95% CI, 1.01-1.38). CONCLUSION Our study demonstrated a statistically significant increased risk of GCA among both current and ever smokers compared to non-smokers.
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8
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Campbell N, Milligan W, Iliopoulos J, Farmer E. Keep off the grass: Cannabis abuse and vasculitis in a teenager. SONOGRAPHY 2018. [DOI: 10.1002/sono.12134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- N. Campbell
- Liverpool Vascular Laboratory; NSW Australia
| | - W. Milligan
- Liverpool Vascular Laboratory; NSW Australia
| | | | - E. Farmer
- Liverpool Vascular Laboratory; NSW Australia
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9
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Accelerated atheromatosis and arteriosclerosis in primary systemic vasculitides: current evidence and future perspectives. Curr Opin Rheumatol 2018; 30:36-43. [DOI: 10.1097/bor.0000000000000453] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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10
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Liozon E. Improving diagnosis and prognosis in giant cell arteritis: Still more issues than answers. Eur Geriatr Med 2017. [DOI: 10.1016/j.eurger.2017.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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11
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12
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Zielińska KA, Van Moortel L, Opdenakker G, De Bosscher K, Van den Steen PE. Endothelial Response to Glucocorticoids in Inflammatory Diseases. Front Immunol 2016; 7:592. [PMID: 28018358 PMCID: PMC5155119 DOI: 10.3389/fimmu.2016.00592] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 11/29/2016] [Indexed: 12/16/2022] Open
Abstract
The endothelium plays a crucial role in inflammation. A balanced control of inflammation requires the action of glucocorticoids (GCs), steroidal hormones with potent cell-specific anti-inflammatory properties. Besides the classic anti-inflammatory effects of GCs on leukocytes, recent studies confirm that endothelial cells also represent an important target for GCs. GCs regulate different aspects of endothelial physiology including expression of adhesion molecules, production of pro-inflammatory cytokines and chemokines, and maintenance of endothelial barrier integrity. However, the regulation of endothelial GC sensitivity remains incompletely understood. In this review, we specifically examine the endothelial response to GCs in various inflammatory diseases ranging from multiple sclerosis, stroke, sepsis, and vasculitis to atherosclerosis. Shedding more light on the cross talk between GCs and endothelium will help to improve existing therapeutic strategies and develop new therapies better tailored to the needs of patients.
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Affiliation(s)
- Karolina A. Zielińska
- Laboratory of Immunobiology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Laura Van Moortel
- Receptor Research Laboratories, Nuclear Receptor Lab, VIB-UGent, VIB Medical Biotechnology Center, Ghent, Belgium
| | - Ghislain Opdenakker
- Laboratory of Immunobiology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Karolien De Bosscher
- Receptor Research Laboratories, Nuclear Receptor Lab, VIB-UGent, VIB Medical Biotechnology Center, Ghent, Belgium
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13
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Agra RM, Al-Daghri NM, Badimon L, Bodi V, Carbone F, Chen M, Cubedo J, Dullaart RPF, Eiras S, García-Monzón C, Gary T, Gnoni A, González-Rodríguez Á, Gremmel T, Hafner F, Hakala T, Huang B, Ickmans K, Irace C, Kholová I, Kimer N, Kytö V, März W, Miazgowski T, Møller S, Montecucco F, Niccoli G, Nijs J, Ozben S, Ozben T, Papassotiriou I, Papastamataki M, Reina-Couto M, Rios-Navarro C, Ritsch A, Sabico S, Seetho IW, Severino A, Sipilä J, Sousa T, Taszarek A, Taurino F, Tietge UJF, Tripolino C, Verloop W, Voskuil M, Wilding JPH. Research update for articles published in EJCI in 2014. Eur J Clin Invest 2016; 46:880-94. [PMID: 27571922 DOI: 10.1111/eci.12671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 08/26/2016] [Indexed: 02/05/2023]
Affiliation(s)
- Rosa María Agra
- Department of Cardiology and Coronary Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
| | - Nasser M Al-Daghri
- Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia.,Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Lina Badimon
- Cardiovascular Research Center (CSIC-ICCC), Barcelona, Spain.,Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain.,Cardiovascular Research Chair, UAB, Barcelona, Spain
| | - Vicente Bodi
- Cardiology Department, Hospital Clinico Universitario, INCLIVA, University of Valencia, Valencia, Spain
| | - Federico Carbone
- First Clinical of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Mao Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Judit Cubedo
- Cardiovascular Research Center (CSIC-ICCC), Barcelona, Spain.,Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Robin P F Dullaart
- Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Sonia Eiras
- Health Research Institute, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Carmelo García-Monzón
- Liver Research Unit, Santa Cristina University Hospital, Instituto de Investigación Sanitaria Princesa, CIBEREHD, Madrid, Spain
| | - Thomas Gary
- Division of Angiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Antonio Gnoni
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Águeda González-Rodríguez
- Liver Research Unit, Santa Cristina University Hospital, Instituto de Investigación Sanitaria Princesa, CIBEREHD, Madrid, Spain
| | - Thomas Gremmel
- Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Franz Hafner
- Division of Angiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Tommi Hakala
- Department of Surgery, Tampere University Hospital, Tampere, Finland
| | - Baotao Huang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kelly Ickmans
- Pain in Motion International Research Group, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - Concetta Irace
- Department of Clinical and Experimental Medicine, University Magna Graecia, Catanzaro, Italy
| | - Ivana Kholová
- Department of Pathology, Fimlab Laboratories, Tampere University Hospital, Tampere, Finland
| | - Nina Kimer
- Department of Clinical Physiology and Nuclear Medicine, Center for Functional and Diagnostic Imaging and Research, Faculty of Health Sciences, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Ville Kytö
- Heart Center, Turku University Hospital, Turku, Finland.,Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Winfried März
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.,Vth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Synlab Academy, Synlab Holding Deutschland GmbH, Mannheim, Augsburg, Germany
| | - Tomasz Miazgowski
- Department of Hypertension and Internal Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Søren Møller
- Department of Clinical Physiology and Nuclear Medicine, Center for Functional and Diagnostic Imaging and Research, Faculty of Health Sciences, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Fabrizio Montecucco
- First Clinical of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy.,IRCCS AOU San Martino-IST, Genoa, Italy.,Centre of Excellence for Biomedical Research (CEBR), University of Genoa, Genoa, Italy
| | | | - Jo Nijs
- Pain in Motion International Research Group, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - Serkan Ozben
- Department of Neurology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Tomris Ozben
- Department of Medical Biochemistry, Medical Faculty, Akdeniz University, Antalya, Turkey
| | - Ioannis Papassotiriou
- Department of Clinical Biochemistry, 'Aghia Sophia' Children's Hospital, Athens, Greece
| | - Maria Papastamataki
- Department of Clinical Biochemistry, 'Aghia Sophia' Children's Hospital, Athens, Greece
| | - Marta Reina-Couto
- Departamento de Farmacologia e Terapêutica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.,MedInUP - Centro de Investigação Farmacológica e Inovação Medicamentosa, Universidade do Porto, Porto, Portugal.,Departamento de Medicina Intensiva, Centro Hospitalar São João, Porto, Portugal
| | - Cesar Rios-Navarro
- Cardiology Department, Hospital Clinico Universitario, INCLIVA, University of Valencia, Valencia, Spain
| | - Andreas Ritsch
- Department of Internal Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Shaun Sabico
- Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia.,Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Ian W Seetho
- Obesity and Endocrinology Research Group, University Hospital Aintree, University of Liverpool, Liverpool, UK
| | | | - Jussi Sipilä
- North Karelia Central Hospital, Joensuu, Finland.,Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland.,Department of Neurology, University of Turku, Turku, Finland
| | - Teresa Sousa
- Departamento de Farmacologia e Terapêutica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.,MedInUP - Centro de Investigação Farmacológica e Inovação Medicamentosa, Universidade do Porto, Porto, Portugal
| | - Aleksandra Taszarek
- Department of Hypertension and Internal Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Federica Taurino
- Department of Biological and Environmental Sciences and Technologies, University of Salento, Lecce, Italy
| | - Uwe J F Tietge
- Department of Pediatrics, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Cesare Tripolino
- Department of Clinical and Experimental Medicine, University Magna Graecia, Catanzaro, Italy
| | - Willemien Verloop
- Department of Cardiology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Michiel Voskuil
- Department of Cardiology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - John P H Wilding
- Obesity and Endocrinology Research Group, University Hospital Aintree, University of Liverpool, Liverpool, UK
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14
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The prediction and monitoring of toxicity associated with long-term systemic glucocorticoid therapy. Curr Rheumatol Rep 2016; 17:513. [PMID: 25903665 DOI: 10.1007/s11926-015-0513-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Glucocorticoids are often required for adequate control of inflammation in many serious inflammatory diseases; common indications for long-term treatment include polymyalgia rheumatica, giant cell arteritis, asthma and chronic obstructive pulmonary disease. Long-term glucocorticoid therapy is, however, associated with many adverse effects involving skin, gastro-intestinal, eye, skeletal muscle, bone, adrenal, cardio-metabolic and neuropsychiatric systems. This balance between benefits and risks of glucocorticoids is important for clinical practice and glucocorticoid-related adverse effects can significantly impair health-related quality of life. Understanding the nature and mechanisms of glucocorticoid-related adverse effects may inform how patients are monitored for toxicity and identify those groups, such as older people, that may need closer monitoring. For clinical trials in diseases commonly treated with glucocorticoids, standardised measurement of glucocorticoid-related adverse effects would facilitate future evidence synthesis and meta-analysis.
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15
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Ungprasert P, Upala S, Sanguankeo A, Warrington KJ. Patients with giant cell arteritis have a lower prevalence of diabetes mellitus: A systematic review and meta-analysis. Mod Rheumatol 2015; 26:410-4. [PMID: 26381748 DOI: 10.3109/14397595.2015.1081722] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study is to compare the prevalence of diabetes mellitus (DM) in patients who are recently diagnosed with giant cell arteritis (GCA) with age- and sex-matched controls. METHODS We conducted a systematic review and meta-analysis of observational studies that (1) consisted of GCA cohort and non-GCA cohort that was randomly selected from the same population and (2) provided prevalences of DM at the time of diagnosis for patients with GCA and at the index date for controls. Pooled odds ratios and 95% confidence intervals (CIs) were calculated using a random-effect, Mantel-Haenszel analysis. RESULTS Five studies with 903 patients with GCA and 1064 controls were identified and included in our data analysis. We demonstrated a statistically significant lower prevalence of DM among patients with GCA with the pooled OR of 0.74 (95% CI, 0.57-0.97). CONCLUSION At diagnosis, patients with GCA had a lower prevalence of DM. Whether DM could be a protective factor against the development of GCA needs further investigations.
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Affiliation(s)
- Patompong Ungprasert
- a Department of Internal Medicine , Division of Rheumatology, Mayo Clinic , Rochester , MN , USA .,b Department of Medicine , Faculty of Medicine Siriraj Hospital, Division of Rheumatology , Bangkok , Thailand , and
| | - Sikarin Upala
- c Department of Medicine , Bassett Medical Center , New York , NY , USA
| | - Anawin Sanguankeo
- c Department of Medicine , Bassett Medical Center , New York , NY , USA
| | - Kenneth J Warrington
- a Department of Internal Medicine , Division of Rheumatology, Mayo Clinic , Rochester , MN , USA
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